The Affordable Care Act: Laying Out the Details in One Place

An Itemized List of Savings and Revenues

Today, over at The American Prospect, Robert Kuttner makes an important point: “in 2010 Republicans convinced a lot of seniors that the Affordable Care Act would come at the expense of Medicare. In truth, you can demonstrate that the ACA will actually save costs without cutting care,” he adds. But to do that, “you have to get so far down in the weeds of health policy that you lose most voters.”

Kuttner is right: the truth lies in the details, and this makes it difficult to explain the Affordable Care Act (ACA) to the public. If Congress had chosen to pay for health care reform by slashing doctors’ fees by 20 percent, and capping how much Medicare will spend on anyone over the age of 75, it would be far easier to sum up the ACA in a few pithy paragraphs.

Instead, legislators focused on trimming $19 billion here, saving $145 billion there, and another $20 billion over there, by; closing tax loopholes, phasing out overpayments to those private sector Advantage insurers that are not delivering  good value for Medicare dollars, and eliminating redundancies within Medicare. These are just a few of the ways that the legislation squeezes some of the waste out of Medicare spending without cutting benefits, or reducing reimbursements to doctors. In addition, reform legislation raises new revenues, including $107 billion in new fees that insurers, drug makers, and medical device companies have agreed to pay. (They can afford to contribute to reform because they know the legislation will bring them millions of new customers.)

I have written a few posts that delve into the details of how “The Affordable Care Act Pays for Itself and Cuts the Deficit.” And now I have put all the numbers together in an issue brief titled “Better Care for Less.”

Granted, it takes more than a few pages to lay everything out, itemizing and explaining both savings and new revenues. This is why you won’t find a detailed breakdown of the ACA in the newspaper, or even on the blogosphere. Most bloggers believe that they must be brief. I should add that I admire tight one-page overviews of reform legislation, but I also think there is a place for clear in-depth analysis of the most important piece of legislation this nation has seen in more than 45 years.

You may not want to sit down and read “Better Care For Less” in one sitting, but I hope you’ll find it a useful resource that will answer many of your questions about the ACA. It may also help you explain reform legislation to skeptical friends. You can click here to download the brief from The Century Foundation’s website.

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